Journal of thoracic disease最新文献

{"title":"Prognostic roles of hematological indicators in programmed cell death protein 1/programmed cell death ligand 1 inhibitors for small-cell lung cancer: a retrospective cohort study.","authors":"Jiya Du, Qian Zhang, Le Tian, Yishan Chen, Ye Tian, Wolfram C M Dempke, Hugo Arasanz, Ross Andrew Soo, Zhiguo Zhou, Qingju Meng, Yibing Liu","doi":"10.21037/jtd-24-1826","DOIUrl":"10.21037/jtd-24-1826","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is the main cause of cancer death in the world, with small-cell lung cancer (SCLC) accounting for about 10-15% of all lung cancers. Although programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors represent a major breakthrough in SCLC treatment, only a minority of patients will benefit and there is still a lack of accurate biomarkers to guide clinical application. Inflammation plays a crucial role in tumorigenesis, tumor development, metastasis, and drug resistance, but there is limited research on the predictive value of these inflammatory indicators in SCLC. The purpose of our study was to determine the influence of prognostic nutritional index (PNI), systemic immune inflammation (SII), and other indexes on the efficacy and prognosis of patients with SCLC treated with PD-1/PD-L1 inhibitors.</p><p><strong>Methods: </strong>A total of 700 patients of SCLC treated with PD-1/PD-L1 inhibitors in the Fourth Hospital of Hebei Medical University from January 2019 to January 2023 were retrospectively analysed. Among these patients, 246 were included after the inclusion and exclusion criteria were applied. The basic clinical data of patients were collected, included age, sex, PD-1 or PD-L1 inhibitors and so on. The neutrophil:lymphocyte ratio (NLR), platelet:lymphocyte ratio (PLR), PNI, SII, and monocyte:lymphocyte ratio (MLR) were calculated. SPSS 27 software was employed for statistical analysis. As of 1st March 2023, all patients had received a post-diagnosis follow-up. The median follow-up time was 11.7 months.</p><p><strong>Results: </strong>Among the 246 patients with SCLC receiving PD-1/PD-L1 inhibitor treatment. the overall response rate and disease control rate were 47.6% and 89.8%, respectively. Median progression-free survival (PFS) and median overall survival (OS) were 9.0 months and 21.4 months, respectively. Multivariate analysis showed that MLR [hazard ratio (HR) =0.631; P=0.01], and platelet (PLT) count (HR =1.641; P=0.009) were independent risk factors for PFS. NLR (HR =0.566, P=0.01) and lactate dehydrogenase (LDH) (HR =0.446; P=0.002) were independent risk factors for OS.</p><p><strong>Conclusions: </strong>Among patients with SCLC treated with PD-1/PD-L1 inhibitors, those with high MLR and low PLT had shorter PFS, whilst patients with high NLR and LDH had a shorter OS. NLR and LDH may be used as prognostic biomarkers patients with SCLC treated with PD-1/PD-L1 inhibitors. The promising clinical application of NLR and LDH in efficacy prognostic indicators and beneficiary selection for SCLC immunotherapy is highlighted.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8669-8683"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory markers as predictors of in-hospital mortality in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with acute respiratory failure: insights from the MIMIC-IV database.","authors":"Qimin Wang, Feng Yang, Lianjun Gao, Cuiping Xu, Wei Gao","doi":"10.21037/jtd-24-1287","DOIUrl":"10.21037/jtd-24-1287","url":null,"abstract":"<p><strong>Background: </strong>Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) particularly when coupled with acute respiratory failure (ARF), markedly elevates mortality rates. This investigation focuses on pivotal inflammatory markers in exacerbations of chronic obstructive pulmonary disease (COPD), including the neutrophil-to-lymphocyte ratio (NLR), lactate-to-albumin ratio (LAR), glucose-to-lymphocyte ratio (GLR), prognostic nutritional index (PNI), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), which are easily determinable from peripheral blood. We aimed to investigate the prognostic value of NLR, LAR, GLR, SII, PNI, and PLR for in-hospital mortality among AECOPD patients with ARF.</p><p><strong>Methods: </strong>This analysis encompassed data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, involving patients diagnosed with AECOPD and ARF. The study employed multivariate logistic regression and restricted cubic spline (RCS) models to evaluate the relationship between selected inflammatory markers and in-hospital mortality. The efficacy of these markers as prognostic tools was further assessed through receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The study included 1,209 AECOPD patients with ARF, comprising 1,137 survivors and 72 fatalities, yielding an in-hospital mortality rate of 5.96%. Both NLR and PNI demonstrated non-linear relationships with mortality outcomes in RCS analysis, with inflection points at 6.66 and 43.54, respectively. Elevated GLR were linked with increased mortality risk. These results persisted even after adjusting for covariates. No significant associations were found for SII, LAR, or PLR. Notably, NLR [area under the curve (AUC) =0.684; 95% confidence interval (CI): 0.627-0.741] slightly surpassed PNI (AUC =0.663; 95% CI: 0.557-0.691) and GLR (AUC =0.624; 95% CI: 0.557-0.691) in predictive accuracy.</p><p><strong>Conclusions: </strong>NLR, GLR, and PNI on admission to hospital have moderate predictive utility for in-hospital mortality in patients with AECOPD and ARF. The findings may provide some references for exploring prognostic biomarkers and help clinicians to identify patients with AECOPD and ARF at elevated risk of mortality in an early stage.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8250-8261"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between health-related quality of life and perioperative exercise capacity in older postoperative patients with non-small cell lung cancer.","authors":"Masato Oikawa, Masatoshi Hanada, Hiroki Nagura, Rina Takeuchi, Takuro Miyazaki, Ryoichiro Doi, Shuntaro Sato, Keitaro Matsumoto, Ryo Kozu","doi":"10.21037/jtd-24-1265","DOIUrl":"https://doi.org/10.21037/jtd-24-1265","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer represents a significant global health concern and constitutes the primary cause of cancer-related mortality. Complete surgical resection with curative intent remains the most efficacious treatment modality for improving the survival rate of patients with localized lung cancer. Average life expectancy has increased in many countries, and the number of older patients undergoing surgery has increased. We aimed to evaluate the change in health-related quality of life (HRQOL) during perioperative lung resection and the association between HRQOL and perioperative physical function (PF) in older patients with lung cancer.</p><p><strong>Methods: </strong>This prospective observational study was conducted in a single tertiary university hospital. Patients aged ≥70 years who underwent lung resection between 1 April 2013 and 31 December 2020 were included. HRQOL was assessed utilizing the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) preoperatively and at 1, 3, and 6 months postoperatively. PF was evaluated using the handgrip, quadriceps force, and 6-minute walking distance (6MWD) tests preoperatively and 1 week after surgery. We analyzed a model for total HRQOL and each domain of HRQOL scores at different time points using a mixed-effects model for repeated measures. A multiple regression analysis was performed to estimate the associations between changes in total HRQOL scores following surgery and clinically relevant factors.</p><p><strong>Results: </strong>In total, 260 patients (172 with stage IA disease, 162 men; median age, 75 years) were included in the analysis. The median preoperative total HRQOL score was 90.1 points, while the scores at postoperative 1, 3, and 6 months were 81.5, 87.5, and 87.4 points, respectively. The total HRQOL score at baseline and the decline in postoperative 6MWD were significant predictors of the total HRQOL score at each time point.</p><p><strong>Conclusions: </strong>HRQOL recovered to preoperative levels 3 months after surgery; the 6MWD decrease before and after surgery was associated with HRQOL recovery than other clinically relevant factors. These results suggest the importance of active early mobilization in preventing functional decline during hospitalization and continuing exercise training after discharge.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8300-8308"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting prognosis of locally advanced esophageal squamous cell carcinoma through early changes in neutrophil-to-lymphocyte ratio following neoadjuvant immunochemotherapy.","authors":"Yizhang Chen, Shujie Huang, Rixin Chen, Zihua Lan, Zhen Gao, Zijie Li, Sichao Wang, Yong Tang, Guibin Qiao","doi":"10.21037/jtd-24-1115","DOIUrl":"https://doi.org/10.21037/jtd-24-1115","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of neoadjuvant immunochemotherapy (NAIC) in locally advanced esophageal squamous cell carcinoma (ESCC) remains unclear. This study aims to validate the relation between early alterations in neutrophil-to-lymphocyte ratio (NLR) and clinical outcomes among individuals diagnosed with locally advanced ESCC undergoing NAIC.</p><p><strong>Methods: </strong>We retrospectively enrolled a cohort of ESCC patients who underwent NAIC at least 1 cycle between May 2020 and October 2021 at Guangdong Provincial People's Hospital. Blood tests were conducted both at the baseline and following the initial treatment cycle. We examined the correlation between NLR-Δ [(cycle 1 NLR - baseline NLR)/baseline NLR × 100%] and overall survival (OS) in ESCC patients.</p><p><strong>Results: </strong>Ninety-eight patients were enrolled in this study, with a median patient age of 62 years [interquartile range (IQR), 56.0-67.0 years]. The median baseline NLR was 2.63 (1.09-9.23). A total of 39 mortality events were observed after a median follow-up of 37.55 months. Thirty-three patients (33.67%) had NLR-Δ ≤-35%, while 65 patients (66.33%) had NLR-Δ >-35%, patients with NLR-Δ ≤-35% (N=33) exhibited significantly worse OS compared to patients with NLR-Δ >-35% (N=65) (median OS: 28.330 months <i>vs.</i> unreached, P=0.044). The independent prognostic factors for OS in this cohort of patients diagnosed with ESCC were NLR-Δ and the receipt of surgical treatment.</p><p><strong>Conclusions: </strong>Patients with a decrease in NLR value of more than 35% after the first cycle of immunochemotherapy may be associated with a worse clinical outcome in ESCC. NLR-Δ shows potential as an early-detection biomarker for NAIC-treated ESCC.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8230-8239"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness and safety of computed tomography-guided hook-wire localization for secondary video-assisted thoracoscopic surgery: a retrospective study.","authors":"Tian Xia, Ziyue Zhou, Ziyao Fang, Zhuolin Xie, Ziqing Shen, Cheng Ding, Haitong Huang, Yicheng Zhang, Shu Pan, Jun Zhao","doi":"10.21037/jtd-24-1342","DOIUrl":"https://doi.org/10.21037/jtd-24-1342","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Computed tomography (CT)-guided hook-wire localization is currently the most commonly used technique for preoperative localization of pulmonary nodules in clinical practice. With the increasing incidence of multiple primary lung cancers and the increasing occurrence of second primary lung cancers or local recurrences after lung cancer surgery, some patients need to undergo an ipsilateral or contralateral second pulmonary resection. In order to reduce the surgical difficulty of the second operation and accurately guide the surgical resection, preoperative localization of some nodules is necessary. This study retrospectively analyzed the CT-guided hook-wire localization information of patients undergoing a second ipsilateral or contralateral video-assisted thoracoscopic surgery (VATS), discussed the safety and effectiveness of hook-wire localization for ipsilateral and contralateral surgeries, and analyzed the risk factors for complications after localization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study retrospectively collected data from 113 patients with isolated solitary pulmonary nodules who underwent a second pulmonary resection and completed CT-guided hook-wire localization at The First Affiliated Hospital of Soochow University from January 2020 to June 2024. The patients were divided into contralateral surgery group and ipsilateral surgery group to compare clinical characteristics, localization time, incidence of complications, and other information between the two groups. Logistic regression analysis was used to identify the risk factors for complications associated with the localization methods in each group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared to the contralateral group, the ipsilateral group had a longer interval between the two surgeries, which was 28.0±9.3 months (P&lt;0.001). The maximum diameter of nodules in the ipsilateral group was 10.8±1.7 mm, higher than that in the contralateral group (P&lt;0.001). There were no statistical differences between the two groups in terms of localization time, number of CT scans, depth of the release position, and incidence of complications. In the contralateral group, 25 patients (30.5%) developed pneumothorax, while in the ipsilateral group, there were 2 cases (6.5%), showing a statistically significant difference (P=0.008). In the contralateral group, 3.7% patients developed hemopneumothorax, while the incidence in the ipsilateral group was as high as 16.1% (P=0.04). Localization time [odds ratio (OR) =1.306, P=0.006] and depth of the release position (OR =1.202, P&lt;0.001) were independent risk factors for the overall occurrence of complications and pneumothorax, while thoracic adhesions (OR =4.115, P=0.03) was an independent risk factor for hemopneumothorax. History of localization (OR =0.109, P=0.02) was identified as a protective factor for pneumothorax.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CT-guided hook-wire localization can effectively complete the localization o","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8350-8362"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phoenix Comprehensive Assessment of Pectus Excavatum Symptoms (PCAPES).","authors":"Dawn E Jaroszewski, Mohamed R Aly, Kenan A Shawwaf, J Asher Jenkins, Ryan Moosavi, Rawan M Zeineddine, Ahmed E Khedr, Beth Sandstrom, Chona Cortez, Juan M Farina","doi":"10.21037/jtd-24-1325","DOIUrl":"https://doi.org/10.21037/jtd-24-1325","url":null,"abstract":"<p><strong>Background: </strong>Pectus excavatum (PE) can cause cardiopulmonary compression with a wide range of symptoms and psychosocial effects. Few validated surveys assess the extensive symptomatology of the adult pectus population. A comprehensive symptom survey was developed and validated with outcomes presented.</p><p><strong>Methods: </strong>An observational and validation study of a novel symptom survey [Phoenix Comprehensive Assessment of Pectus Excavatum Symptoms (PCAPES)] was performed that included patients evaluated for PE from October 2020-September 2021 at Mayo Clinic Arizona. Survey validation was performed in three phases.</p><p><strong>Results: </strong>After survey validation, 432 patients completed the PCAPES survey: median age was 30 years [interquartile range (IQR), 23.0, 39.9 years], 57.8% males, median Haller index: 4.2 (IQR, 3.6, 5.4). Common neurological complaints included headaches (74%) and positional dizziness (67%). Regarding cardiovascular symptoms, 6/7 exercise related questions had at least 70% of patients reporting limitations or inability to perform. Pulmonary-wise, >80% noted restricted breathing both with normal activity and during exercise. For gastrointestinal symptoms, nearly half reported some degree of dysphagia with 52% noting post-prandial dyspnea. Psychosocially, patients reported either avoiding activities where their chest could be visible (68%) or feeling bothered by the overall appearance of their chest (80%). Commonly reported complaints were feelings of depression and anxiety (65% each). Females and older patients (≥30) were more severely affected with cardiac symptoms (P<0.05 for all comparisons). Despite being more symptomatic, females were more likely to feel dismissed by their physicians.</p><p><strong>Conclusions: </strong>Pectus causes a variety of symptoms, and a comprehensive survey should be performed for assessment and indication of further testing.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8565-8581"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of anesthesia methods and rapid on-site evaluation on the diagnosis of lung cancer using endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective study.","authors":"Yu-He Hu, Wen-Hui Xu, Yu-Ying Li","doi":"10.21037/jtd-24-1117","DOIUrl":"https://doi.org/10.21037/jtd-24-1117","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a critical method for diagnosing lung cancer. While EBUS-TBNA is commonly performed under conscious sedation, the potential benefits of conducting the procedure under general anesthesia and incorporating rapid on-site evaluation (ROSE) to enhance diagnostic yield remain uncertain. This study aims to investigate the impact of anesthesia methods and ROSE on the diagnostic efficacy of EBUS-TBNA for lung cancer.</p><p><strong>Methods: </strong>This study collected data from patients who underwent EBUS-TBNA for suspected lung cancer in the Department of Respiratory and Critical Care Medicine at The Affiliated Hospital of Southwest Medical University from August 2018 to December 2023. Patients were categorized into three groups based on the anesthesia method used and whether ROSE was performed: the non-general anesthesia group (NGA group), the general anesthesia group (GA group), and the general anesthesia with ROSE group (RGA group). The study analyzed baseline characteristics, puncture details, diagnostic outcomes, and complications across the groups.</p><p><strong>Results: </strong>The number of puncture needles used in the RGA group was significantly lower than in the other two groups (P<0.001). Most patients received a definitive diagnosis, with malignant tumor diagnostic rates of 80.95%, 85.71%, and 93.44% in the NGA, GA, and RGA groups, respectively (P=0.12). The overall disease diagnostic rates were 76.06%, 79.22%, and 86.11%, respectively (P=0.30). No severe complications occurred in any of the groups. The proportion of patients willing to undergo repeat EBUS-TBNA was significantly lower in the NGA group compared to the other two groups (P=0.002).</p><p><strong>Conclusions: </strong>Compared to local anesthesia combined with intravenous analgesia and sedation or general anesthesia alone, general anesthesia combined with ROSE reduces the number of puncture needles required during EBUS-TBNA but does not further improve diagnostic efficacy.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8493-8502"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung resection and new postoperative home oxygen requirement: a systematic review.","authors":"Wendelyn M Oslock, Rongbing Xie, James Donahue, Benjamin Wei","doi":"10.21037/jtd-24-615","DOIUrl":"https://doi.org/10.21037/jtd-24-615","url":null,"abstract":"<p><strong>Background: </strong>While patients are assessed for their ability to tolerate surgery through physiologic evaluations such as pulmonary function tests, ventilation-perfusion scans, and exercising testing, some patients still require home oxygen therapy after pulmonary resection. It is not well understood what the associated risk factors are, how long patients need supplemental oxygen, and if this requirement is associated with worse long-term outcomes. Given these knowledge gaps, we sought to conduct a systematic review of pulmonary resections and new postoperative home oxygen requirement.</p><p><strong>Methods: </strong>A comprehensive search of PubMed was conducted from inception to August 2023 for studies reporting new home oxygen requirement in adults after pulmonary resection. If all participants were already on home oxygen, if no patients required home oxygen after surgery, or full text was not available in English the study was excluded. Odds ratios from available studies were statistically combined using a meta-analytic approach into a forest plot, allowing for a more precise estimate of the effect size than any single study.</p><p><strong>Results: </strong>A total of 17 studies capturing 26,093 patients, 3,796 of whom were discharged on home oxygen, were included in the review. The majority of studies focused on patients undergoing resection for malignant etiologies. Female sex, White race, obesity, and non-adenocarcinoma histology were most commonly found to be associated with increased risk for home oxygen. Tobacco use and pulmonary function studies [e.g., forced expiratory volume in one second (FEV₁) and diffusing capacity of the lungs for carbon monoxide (DLCO)] lost significance on multivariable analysis. While few of the studies captured duration and outcomes associated with home oxygen, the ones that did found that nearly 50% of patients were still on home oxygen after 6 months and that the need for home oxygen even during the first month was associated with increased risk for mortality.</p><p><strong>Conclusions: </strong>Requiring home oxygen after surgery may be associated with worse outcomes. Additional studies on the factors associated with requiring postoperative home oxygen are needed. This would allow for more accurate preoperative counseling as well as target modifiable risk factors for optimization.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8796-8806"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of CT characteristics of osteosarcoma lung metastases with spontaneous pneumothorax: a retrospective analysis.","authors":"Jianqi Li, Chengfen Deng, Jun Yuan, Haolin Jia, Lin Peng","doi":"10.21037/jtd-24-1015","DOIUrl":"https://doi.org/10.21037/jtd-24-1015","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous pneumothorax (SP) has been reported to be associated with osteosarcoma lung metastases, but the computed tomography (CT) characteristics of lung metastases in patients with pneumothorax have not been comprehensively described. The study aimed to describe the CT characteristics of lung metastases in patients with osteosarcoma and to identify factors associated with SP.</p><p><strong>Methods: </strong>This study comprised 123 patients diagnosed with osteosarcoma lung metastasis at our hospital between January 2016 and December 2021. Demographics, tumor characteristics at initial diagnosis, the time interval between diagnosis of lung metastases and pneumothorax, and features of lung metastases on chest CT were documented.</p><p><strong>Results: </strong>A total of 31 patients experienced SP (20 unilateral and 11 bilateral cases). Lung metastases were identified as multiple nodules or masses (39/42 <i>vs.</i> 123/204, P<0.001), with higher rates of cavitation and pleural involvement (23/42 <i>vs.</i> 19/178, P<0.001 and 38/42 <i>vs.</i> 63/178, P<0.001, respectively) in patients with pneumothorax. A considerable prevalence of calcification (123/220) was observed in lung metastases. However, no statistically significant difference was found between patients with and without pneumothorax. The duration of detection of lung metastases was shorter in patients with pneumothorax than in those without it (6 <i>vs.</i> 11 months, P=0.039). Binary logistic regression analysis revealed that only the presence of cavitation and pleural involvement of lung metastases were significantly associated with pneumothorax, with odds ratios of 12.430 [95% confidence interval (CI): 3.011-51.320; P<0.001] and 15.480 (95% CI: 4.038-59.348; P<0.001), respectively.</p><p><strong>Conclusions: </strong>SP can occur in the region of lung metastases near the pleura following the formation and bursting of cavities. Regular follow-up of these patients has the potential to ensure early detection and treatment of pneumothorax.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8417-8423"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive bioinformatics analysis of prognosis and immunotherapy in lung adenocarcinoma.","authors":"Ling Peng, Luping Xia, Meiyu Yang, Yali Wen, Qinghua Zeng","doi":"10.21037/jtd-24-1530","DOIUrl":"https://doi.org/10.21037/jtd-24-1530","url":null,"abstract":"<p><strong>Background: </strong>Research has shown that genetic mutations play an important role in the prognosis of lung adenocarcinoma (LUAD). However, the genes that influence the prognosis and immunotherapy of lung cancer patients have not yet been thoroughly studied. In this study, data from The Cancer Genome Atlas (TCGA) Program and other databases were used to identify the survival-related genes in LUAD.</p><p><strong>Methods: </strong>First, the TCGA database was used to screen key LUAD genes. Second, the Gene Expression Profiling Interactive Analysis 2 (GEPIA2), University of ALabama at Birmingham CANcer (UALCAN), Tumor IMmune Estimation Resource (TIMER), Kaplan-Meier plotter, and cBioPortal databases, and a univariate Cox analysis combined with a random forest (RF) model were used to estimate gene expression, patient prognosis, and gene mutations, respectively. TIMER was also used to predict the immune function of the genes.</p><p><strong>Results: </strong>A total of 2,138 up-regulated and 2,559 down-regulated differentially expressed genes (DEGs) were identified from TCGA-LUAD dataset. Next, four prognostic genes (i.e., <i>CENPH</i>, <i>SLC35F4</i>, <i>TESMIN</i>, and <i>TERT</i>) were identified as the key genes. The expression levels of all four genes were higher in LUAD tissues than those in the normal lung tissues, but only <i>CENPH</i> and <i>TESMIN</i> were correlated with poor overall survival (OS). The four genes were also found to be associated with immunoinfiltration.</p><p><strong>Conclusions: </strong>Of the four key genes identified, <i>CENPH</i> and <i>TESMIN</i> would not only contribute to the diagnosis and prognosis of LUAD but could also serve as potential immunotherapy targets for LUAD.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 12","pages":"8633-8647"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}